- Heartburn Slideshow: Foods to Eat, Foods to Avoid
- 10 Facts About the Amazing Brain
- Weight Gain Shockers Slideshow Pictures
- What is mycophenolate mofetil-oral, and how does it work (mechanism of action)?
- What brand names are available for mycophenolate mofetil-oral?
- Is mycophenolate mofetil-oral available as a generic drug?
- Do I need a prescription for mycophenolate mofetil-oral?
- What are the side effects of mycophenolate mofetil-oral?
- What is the dosage for mycophenolate mofetil-oral?
- Which drugs or supplements interact with mycophenolate mofetil-oral?
- Is mycophenolate mofetil-oral safe to take if I'm pregnant or breastfeeding?
- What else should I know about mycophenolate mofetil-oral?
What is mycophenolate mofetil-oral, and how does it work (mechanism of action)?
Mycophenolic acid is an immunosuppressive drug. Mycophenolate mofetil is a prodrug (inactive form) of mycophenolic acid (MPA). Following oral administration, mycophenolate mofetil is rapidly absorbed and hydrolyzed (converted) to MPA. MPA is the active metabolite which has pharmacological activity.
MPA is a strong, reversible inhibitor of inosine monophosphate dehydrogenase (IMPDH). IMPDH plays a critical role in the production of DNA. T and B lymphocytes (immune cells) are heavily dependent on the activity of IMPDH to make DNA to proliferate, whereas other cells can use alternative pathways. In patients who have received transplanted organs, the recipient's immune system attacks the transplanted organ because the body perceives it as foreign or harmful. MPA decreases the activity of the immune system by inhibiting the proliferation of immune cells that attack the transplanted organ. Mycophenolate is used with other medications that also inhibit the rejection of transplanted organs such as cyclosporine (Sandimmune, Gengraf, Neoral) and corticosteroids.
Mycophenolate mofetil was approved by the U.S. FDA on May 3, 1995.
What are the side effects of mycophenolate mofetil-oral?
Common side effects include:
- pain in the stomach area,
- high blood pressure, and
- swelling of the lower legs, ankles, or feet.
It may also cause:
Quick GuidePrescription Drug Abuse: Know The Warning Signs
What is the dosage for mycophenolate mofetil-oral?
Mycophenolate mofetil should be given to patients as soon as possible following organ transplantation. Mycophenolate mofetil is recommended to be administered on an empty stomach, except in stable renal transplant patients in whom it can be administered with food if necessary.
- Adults: The recommended dose is 1 g administered orally or intravenously (over no less than 2 hours) twice a day.
- Pediatrics (3 months to 18 years of age): The recommended dose of the oral suspension is 600 mg/m2 administered twice daily (maximum daily dose of 2 g/10 ml). Patients with a body surface area of 1.25 m2 to 1.5 m2 may be administered capsules at a dose of 750 mg twice daily. Patients with a body surface area >1.5 m2 may be dosed with capsules or tablets at a dose of 1 g twice daily.
- Adults: The recommended dose is 1.5 g twice daily administered intravenously over no less than 2 hours or 1.5 g orally twice daily.
- Adults: The recommended dose is 1 g twice daily administered intravenously over no less than 2 hours or 1.5 g orally twice daily.
- Geriatrics (elderly patients): The recommended oral dose is 1 g twice daily for kidney transplant patients, 1.5 g twice daily for heart transplant patients, and 1 g twice daily administered intravenously or 1.5 g twice daily administered orally in liver transplant patients.
Which drugs or supplements interact with mycophenolate mofetil-oral?
Co-administration of acyclovir (Zovirax) or ganciclovir (Cytovene, Vitrasert, Zirgan) and mycophenolate mofetil may cause an increase in blood levels of mycophenolate mofetil and the interacting drug since these drugs compete with each other for elimination via the kidneys.
Antacids containing magnesium or aluminum hydroxide may decrease MPA blood levels. If combination use is necessary, administration of the two medications must be separated by several hours.
Proton pump inhibitors (PPIs) such as lansoprazole (Prevacid), pantoprazole (Protonix), and omeprazole (Prilosec) have been shown to reduce MPA blood levels. This effect may be due to a decrease in mycophenolate mofetil solubility caused by reduced acid secretion in the stomach caused by PPIs.
Cyclosporine (Sandimmune) may decrease MPA blood levels. Cyclosporine inhibits multidrug-resistant-associated protein 2 (MRP-2) transporter in the biliary tract, and this prevents the excretion of MPA into bile and elimination from the body.
Mycophenolate mofetil may decrease the effectiveness of some oral contraceptives (birth control pills). Combining mycophenolate mofetil with birth control pills should be done cautiously, and additional contraceptive barriers (such as condoms) should be used.
Sevelamer (Renvela) may decrease MPA blood levels. Sevelamer and other calcium free phosphate binders that are used for treating patients with kidney disease should not be administered with mycophenolate mofetil. If combination treatment is necessary, sevelamer and other calcium free phosphate binders must be given two hours after mycophenolic acid administration.
Norfloxacin (Noroxin) and metronidazole (Flagyl), two antibiotics, may decrease MPA blood levels. Use of these antibiotics with mycophenolate mofetil is not recommended. Other antibiotics that may also decrease MPA levels in the blood are ciprofloxacin (Cipro), amoxicillin plus clavulanic acid (Augmentin), and rifampin (Rifadin, Rimactane).
Probenecid may cause an increase in MPA blood levels by inhibiting its excretion via renal tubular secretion.
Is mycophenolate mofetil-oral safe to take if I'm pregnant or breastfeeding?
Mycophenolate mofetil is excreted in milk of rats. It is not known if it also is excreted in human milk. Due to the lack of conclusive safety data, mycophenolate mofetil should be used cautiously in nursing mothers.
What else should I know about mycophenolate mofetil-oral?
What preparations of mycophenolate mofetil-oral are available?
- Powder for injection: 500 mg
- Capsules: 250 mg
- Immediate-release tablets: 500 mg
- Delayed-release tablets: 180 and 360 mg
- Oral suspension: 200 mg/ml
How should I keep mycophenolate mofetil-oral stored?
- Capsules and tablets should be stored at room temperature, between 15 C and 30 C (59 F and 86 F).
- Oral suspension may be stored at room temperate between 15 C and 30 C (59 F and 86 F) for up to 60 days.
- Oral suspension also may be stored in the refrigerator between 2 C and 8 C (36 F and 46 F), but it should not be frozen.
REFERENCE: FDA Prescribing Information.
Quick GuidePrescription Drug Abuse: Know The Warning Signs
Mycophenolate mofetil (CellCept) is a drug prescribed for the prophylaxis of organ rejection in people receiving kidney, heart, or liver transplants. Side effects, drug interactions, warnings, precautions, dosing, storage, pregnancy, and breastfeeding safety information should be reviewed prior to taking this drug.
Multimedia: Slideshows, Images & Quizzes
Kidney Disease Quiz: Test Your Medical IQ
Kidney disease is common. Take this kidney disease quiz to test your knowledge and learn the symptoms, causes and types of kidney...
Liver Disease Quiz: Fatty Liver Disease, Cirrhosis & Symptoms
What is liver disease? Take the Liver Disease Quiz and test your knowledge about this organ and its function....
Picture of Hair Transplant
Surgical approaches include various versions of hair transplantation (taking hair from the back and putting it near the front) or...
Picture of Liver
Front View of the Liver. The liver is a large, meaty organ that sits on the right side of the belly. See a picture of the Liver...
Picture of Kidneys
The kidneys are a pair of organs located in the back of the abdomen. See a picture of the Kidneys and learn more about the health...
Related Disease Conditions
Kidney Failure (Symptoms, Signs, Stages, Causes, and Treatment)
Kidney failure can occur from an acute event or a chronic condition or disease. Prerenal kidney failure is caused by blood loss,...
Congestive Heart Failure (CHF) Symptoms, Stages, and Prognosis
Congestive heart failure (CHF) refers to a condition in which the heart loses the ability to function properly. Heart disease,...
Cirrhosis of the liver refers to a disease in which normal liver cells are replaced by scar tissue caused by alcohol and viral...
Liver disease can be cause by a variety of things including infection (hepatitis), diseases such as: gallstones, high...
Liver cancer is cancer of the liver cells (hepatocellular carcinoma) or of the ducts in the liver (cholangiocarcinoma). Liver...
Liver (Anatomy and Function)
The liver is the largest gland and organ in the body. There are a variety of liver diseases caused by liver inflammation,...
Heart failure (congestive) is caused by many conditions including coronary artery disease, heart attack, cardiomyopathy, and...
Nonalcoholic fatty liver disease occurs due to the accumulation of abnormal amounts of fat within the liver. Fatty liver most...
Lupus (Systemic Lupus Erythematosus or SLE)
Systemic lupus erythematosus is a condition characterized by chronic inflammation of body tissues caused by autoimmune disease....
Drug-Induced Liver Disease
Drug-induced liver diseases are diseases of the liver that are caused by: physician-prescribed medications, OTC...
Tylenol Liver Damage
Tylenol liver damage (acetaminophen) can occur from accidentally ingesting too much acetaminophen, or intentionally. Signs and...
There are several types of kidney cancer, including renal cell cancer (renal adenocarcinoma or hypernephroma), transitional cell...
Scleritis is inflammation of the white part of the eye. It may be caused by a serious underlying condition, such as an autoimmune...
Myasthenia gravis, a chronic autoimmune neuromuscular disease. Varying degrees of weakness of the voluntary muscles of the body...
Henoch-Schonlein Purpura (HSP or anaphylactoid purpura), a type of blood vessel inflammation, results in rash, arthritis, and...
Bullous pemphigoid is a skin disease that causes blistering eruptions on the skin's surface and sometimes affects the inner...
Diabetes and Kidney Disease
In the United States diabetes is the most common cause of kidney failure. High blood pressure and high levels of blood glucose...
Hypertensive Kidney Disease
High blood pressure can damage the kidneys and is one of the leading causes of kidney failure (end-stage renal kidney disease)....
Graft Versus Host Disease (GVHD)
Graft versus host disease (GVHD) is a condition that happens when immune cells from transplanted donor tissue attack the...
Treatment & Diagnosis
Medications & Supplements
Daily Health News
Drugs and Treatment Resources
Subscribe to MedicineNet's General Health Newsletter
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
Top mycophenolate mofetil-oral Related ArticlesComplete List
CirrhosisCirrhosis of the liver refers to a disease in which normal liver cells are replaced by scar tissue caused by alcohol and viral hepatitis B and C. This disease leads to abnormalities in the liver's ability to handle toxins and blood flow, causing:
- internal bleeding,
- kidney failure,
- mental confusion,
- body fluid accumulation, and
- frequent infections.
Congestive Heart Failure (CHF) OverviewCongestive heart failure (CHF) refers to a condition in which the heart loses the ability to function properly. Heart disease, high blood pressure, diabetes, myocarditis, and cardiomyopathies are just a few potential causes of congestive heart failure. Signs and symptoms of congestive heart failure may include fatigue, breathlessness, palpitations, angina, and edema. Physical examination, patient history, blood tests, and imaging tests are used to diagnose congestive heart failure. Treatment of heart failure consists of lifestyle modification and taking medications to decrease fluid in the body and ease the strain on the heart. The prognosis of a patient with congestive heart failure depends on the stage of the heart failure and the overall condition of the individual.
Heart failure (congestive) is caused by many conditions including coronary artery disease, heart attack, cardiomyopathy, and conditions that overwork the heart. Symptoms of heart failure include
- congested lungs,
- fluid and water retention,
- fatigue and weakness, and
- rapid or irregular heartbeats.
There are two types of congestive heart failure, systolic or left-sided heart failure; and diastolic or right-sided heart failure. Treatment, prognosis, and life-expectancy for a person with congestive heart failure depends upon the stage of the disease.
Heart TransplantHeart transplant consists of three operations: 1) harvesting the heart from the donor, 2) removing the recipient's damaged heart, and 3) the implantation of the donor heart. The selection and distribution of donor hearts is a careful process so that the hearts are distributed fairly. For the patient requiring a heart transplant, all other important organs in the body must be in good shape. The most common complication of heart transplant is organ rejection.
HemodialysisThe most common method used to treat advanced and permanent kidney failure is hemodialysis. Hemodialysis allows your blood to flow through a special filter that removes extra fluids and waste products. Most patients have treatments three times a week. Tests to measure treatment success are performed about once a month. Anemia, erythropoietin, renal osteodystrophy, itching, sleep disorders, and amyloidosis are all complications from dialysis. A proper diet can help improve dialysis and daily health.
Kidney Disease QuizKidney disease is common. Take this kidney disease quiz to test your knowledge and learn the symptoms, causes and types of kidney disease and what foods to eat and avoid!
Kidney failure can occur from an acute event or a chronic condition or disease. Prerenal kidney failure is caused by blood loss, dehydration, or medication. Some of the renal causes of kidney failure include sepsis, medications, rhabdomyolysis, multiple myeloma, and acute glomerulonephritis.
Post renal causes of kidney failure include bladder obstruction, prostate problems, tumors, or kidney stones.Treatment options included diet, medications, or dialysis.
Liver (Anatomy and Function)The liver is the largest gland and organ in the body. There are a variety of liver diseases caused by liver inflammation, scarring of the liver, infection of the liver, gallstones, cancer, toxins, genetic diseases, and blood flow problems. Symptoms of liver disease generally do not occur until the liver disease is advanced. Some symptoms of liver disease include jaundice, nausea and vomiting, easy bruising, bleeding excessively, fatigue, weakness, weight loss, shortness of breath, leg swelling, impotence, and confusion. Treatment of diseases of the liver depend upon the cause.
Liver Cancer Hepatocellular CarcinomaLiver cancer is cancer of the liver cells (hepatocellular carcinoma) or of the ducts in the liver (cholangiocarcinoma). Liver cancer often arises due to liver damage, cirrhosis (scarring) caused by alcohol use/abuse, hepatitis B, or hepatitis C. Liver cancer may not cause any symptoms. Liver cancer is diagnosed with blood tests, imaging tests, and a liver biopsy. Treatment for liver cancer may include surgery, ablation, embolization, radiation, chemotherapy, and targeted therapy.
Liver DiseaseLiver disease can be cause by a variety of things including infection (hepatitis), diseases such as:
- high cholesterol or triglycerides,
- blood flow obstruction to the liver, and
- toxins (medications and chemicals).
- upper right abdominal pain, and
Liver Disease QuizWhat is liver disease? Take the Liver Disease Quiz and test your knowledge about this organ and its function.
Liver PictureFront View of the Liver. The liver is a large, meaty organ that sits on the right side of the belly. See a picture of the Liver and learn more about the health topic.
Liver TransplantA liver transplant may be needed when the liver functions inadequately. Patients on the waiting list for a liver transplant are given a priority score based on their creatinine, bilirubin, and INR. Complications of liver transplantation include rejection of the donor organ and infection.